Selective Serotonin Reuptake Inhibitor (SSRI) updated on 07-01-2025

Neuro-developmental disorders (as a whole)

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S17049
R71335
Suarez (Controls unexposed, discontinuers), 2022 Any Specific Neurodevelopmental Disorder (ASD, ADHD, language disorder, learning disorders, intellectual disability, Developmental Coordination Disorder) 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.13 [1.07;1.20] 8,706/115,060   2,446/38,038 11,152 115,060
ref
S17050
R71343
Suarez (Controls unexposed, general pop), 2022 Any Specific Neurodevelopmental Disorder (ASD, ADHD, language disorder, learning disorders, intellectual disability, Developmental Coordination Disorder) 2nd and/or 3rd trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.15 [1.12;1.19]
excluded (control group)
8,708/115,110   134,866/3,000,907 143,574 115,110
ref
S7462
R22065
Kragholm, 2018 Special education needs in elementary school (from nationwide Danish education registries under Statistics Denmark) - At 3-10 years old during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.34 [0.98;1.85] -/2,279   -/3,956 - 2,279
ref
S10192
R37358
Heikkinen - Fluoxetine only, 2003 Abnormal neurologic development - Modified Gesell developmental schedules (at 1 year) during pregnancy (anytime or not specified) prospective cohort unexposed (general population or NOS) Adjustment: No Monotherapy: no or not specified 0.90 [0.02;50.25] C 0/11   0/10 0 11
ref
Total 3 studies 1.14 [1.07;1.20] 11,152 117,350
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Suarez (Controls unexposed, discontinuers), 2022Suarez, 2022 1 1.13[1.07; 1.20]11,152115,06097%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Kragholm, 2018Kragholm, 2018 1.34[0.98; 1.85]-2,2793%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: lowROB mesure: unclearROB reporting: moderate Heikkinen - Fluoxetine only, 2003Heikkinen - Fluoxetine only, 2003 0.90[0.02; 50.25]0110%ROB confusion: criticalROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Total (3 studies) I2 = 0% 1.14[1.07; 1.20]11,152117,3500.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, discontinuers;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.14[1.07; 1.20]11,152117,3500%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 Heikkinen - Fluoxetine only, 2003 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.90[0.02; 50.25]-11 -NAHeikkinen - Fluoxetine only, 2003 1 unexposed, sickunexposed, sick 1.14[1.05; 1.24]11,152117,3397%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 2 Tags Adjustment   - No  - No 0.90[0.02; 50.25]-11 -NAHeikkinen - Fluoxetine only, 2003 1   - Yes  - Yes 1.14[1.05; 1.24]11,152117,3397%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 2 Monotherapy   - no or not specified  - no or not specified 1.14[1.07; 1.20]11,152117,3500%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 Heikkinen - Fluoxetine only, 2003 3 Unexposed sick   - recent illness/treatment (during o ...  - recent illness/treatment (during or juste before pregnancy or treatment stopped in view of pregnancy) 1.14[1.05; 1.24]11,152117,3397%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 2 All studiesAll studies 1.14[1.07; 1.20]11,152117,3500%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 Heikkinen - Fluoxetine only, 2003 30.25.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 17050

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.15[1.12; 1.19]143,574115,1210%NASuarez (Controls unexposed, general pop), 2022 Heikkinen - Fluoxetine only, 2003 2 unexposed, sick controlsunexposed, sick controls 1.14[1.05; 1.24]11,152117,3397%NASuarez (Controls unexposed, discontinuers), 2022 Kragholm, 2018 20.510.01.0